Table 1.
Descriptive data, VRE cases and antibiotic use of the 61 wards considered in the analysis in total and by type of ward
| Characteristic | Type of hospital ward | ||||
|---|---|---|---|---|---|
| Baseline characteristics | All (n = 61) Median (IQR) |
Surgical (n = 20) N (%)/median (IQR) |
Medical (n = 18) N (%)/median (IQR) |
Intensive Care Unit (n = 14) N (%)/median (IQR) |
Hemato-oncological (n = 9) N (%)/median (IQR) |
| Patients, N = 204,054 | 3260 (1886–4478) | 4180 (2642–5002) | 3849 (3486–4909) | 1483 (1252–1899) | 2031 (1576–2268) |
| Patient-days, N = 948,380 | 14,773 (10,642–19,154) | 16,488 (13,488–19,819) | 17,912 (15,018–20,758) | 8949 (6961–10,642) | 13,722 (10,849–14,430) |
| Average length of stay, d | 4.7 (3.9–5.8) | 4.4 (3.7–5.0) | 4.3 (3.7–5.1) | 5.6 (5.1–7.0) | 6.4 (4.8–8.2) |
| Beds, N = 1604 | 27 (18–32) | 32 (30–33) | 31.5 (26–36) | 13 (10–16) | 21 (18–21) |
| Bed occupancy rate (bed-days/patient-days*100) | 81.1 (77.4–92.6) | 77.2 (67.0–81.5) | 79.1 (78.0–82.4) | 94.9 (94.0–97.2) | 89.5 (81.1–93.1) |
| VRE rates | |||||
| VRE cases (alla), N = 1430 | 12 (5–24) | 5.5 (4.5–12.5) | 7 (3–15) | 20 (13–70) | 48 (33–69) |
| Screening cases, N = 939 (65.7%) | 4 (2–12) | 3.5 (1.5–5) | 3.5 (2–4) | 9 (0–26) | 42 (31–63) |
| Clinical cases, N = 491 (34.3%) | 4 (2–10) | 4 (1.5–6.5) | 3 (1–8) | 12.5 (8–23) | 3 (2–6) |
| VRE cases (nosocomial), N = 409 (28.6%) | 3 (1–7) | 2 (1–4) | 1 (0–4) | 11.5 (5–21) | 5 (3–8) |
| VRE incidence (nosocomial VRE/100 patients) | 0.11 (0.03–0.32) | 0.05 (0.02–0.14) | 0.03 (0–0.11) | 0.68 (0.32–1.22) | 0.29 (0.14–0.53) |
| VRE incidence density (nosocomial VRE/ 1000 patient-days) | 0.24 (0.07–0.54) | 0.11 (0.06–0.27) | 0.07 (0–0.22) | 1.17 (0.71–1.75) | 0.35 (0.24–0.54) |
| Systemic antibiotic use (ATC-code) in DDD/100 patient-days | |||||
| All antibacterials for systemic use (J01) | 76.8 (61.6–131.9) | 72.8 (58.1–83.6) | 64.1 (39.2–72.8) | 163.2 (144.1–200.7) | 115.0 (65.4–123.8) |
| - Beta-lactam antibacterials, penicillins (J01C) | 19.5 (13.8–34.4) | 15.6 (12.1–38.7) | 17.0 (11.5–28.6) | 34.1 (30.1–46.2) | 17.6 (16.1–20.4) |
| - Combinations of penicillins, incl. Beta-lactamase inhibitors (J01CR) | 14.2 (10.6–26.8) | 12.2 (9.5–34.3) | 10.7 (8.4–16.4) | 21.4 (15.9–31.0) | 15.2 (13.7–18.3) |
| - Ampicillin and enzyme inhibitor (J01CR01) | 5.3 (2.5–16.5) | 5.7 (2.8–25.4) | 3.8 (2.4–9.7) | 11.2 (6.5–17.9) | 2.3 (1.0–3.8) |
| - Piperacillin and enzyme inhibitor (J01CR05) | 6.0 (2.6–9.2) | 2.7 (1.6–4.1) | 3.1 (2.0–5.8) | 10.2 (7.2–12.9) | 10.4 (7.4–11.5) |
| - Other beta-lactam antibacterials (J01D) | 21.6 (16.9–37.5) | 18.6 (14.2–29.2) | 18.5 (10.3–22.8) | 57.5 (45.7–68.5) | 20.5 (18.2–34.5) |
| - Second-generation cephalosporins (J01 DC) | 4 (2.6–11.7) | 9.0 (3.4–20.0) | 3.3 (1.9–8.2) | 4.3 (2.7–17.1) | 2.8 (2.1–3.5) |
| - Third-generation cephalosporins (J01DD) | 3.9 (2.2–6.7) | 2.4 (1.2–3.4) | 3.1 (2.0–6.4) | 9.0 (6.6–12.6) | 4.3 (3.5–6.3) |
| - Ceftriaxone (J01DD04) | 2.6 (1.2–4.7) | 1.6 (0.7–2.8) | 2.8 (1.5–5.6) | 4.7 (2.8–5.8) | 1.6 (0.9–2.8) |
| - Carbapenems (J01DH) | 8.4 (2.3–19.0) | 4.6 (1.0–7.5) | 3.2 (1.5–8.4) | 42.3 (22.5–49.4) | 11.8 (10.7–25.7) |
| - Meropenem (J01DH02) | 7.8 (2.2–16.8) | 3.3 (0.8–6.8) | 2.5 (1.5–7.8) | 40.3 (22.1–45.0) | 11.5 (10.4–25.4) |
| - Sulfonamides and Trimethoprim (J01E) | 2.7 (1.4–5.0) | 2.7 (1.4–3.3) | 1.1 (0.6–2.0) | 4.3 (3.1–7.1) | 13.5 (2.7–15.8) |
| - Makrolides, lincosamides and streptogramins (J01F) | 7.3 (4.5–9.4) | 6.4 (3.4–8.4) | 6.2 (4.2–7.8) | 8.8 (6.4–10.5) | 8.0 (7.0–10.4) |
| - Aminoglycosides (J01G) | 0.4 (0.2–1.3) | 0.2 (0.1–0.4) | 0.2 (0.1–0.6) | 3.5 (1.4–7.9) | 0.3 (0.2–0.4) |
| - Quinolones (J01M) | 11.2 (6.8–20.7) | 8.3 (6.1–16.0) | 7.4 (3.7–12.4) | 23.3 (17.9–27.3) | 13.5 (10.2–43.6) |
| - Ciprofloxacin (J01MA02) | 10.5 (6.0–19.0) | 8.0 (5.7–14.1) | 6.9 (3.1–11.0) | 21.6 (17.4–25.2) | 11.1 (9.2–41.9) |
| - Other antibacterials (J01X) | 7.5 (3.5–12.9) | 6.1 (3.2–9.3) | 3.7 (1.7–6.3) | 29.2 (20.8–36.7) | 8.8 (5.1–11.0) |
| - Glycopeptide antibacterials (J01XA) | 3.0 (1.5–8.7) | 1.8 (1.4–3.1) | 1.7 (0.8–2.2) | 12.8 (8.7–19.0) | 5.6 (3.7–9.4) |
| - Vancomycin (J01XA01) | 2.6 (1.5–6.7) | 1.8 (1.4–3.1) | 1.6 (0.8–2.2) | 12.4 (8.7–16.6) | 2.8 (2.6–4.0) |
IQR, interquartile range; VRE, vancomycin-resistant enterococci; ATC, Anatomical Therapeutic Chemical classification system
anosocomial and community acquired VRE